Umhlaza wesisu

Umhlaza we-Colorectal (CRC, kubandakanywa umhlaza we-rectal kunye nomhlaza we-colon) yenye yezona zinto zixhaphakileyo ezinobungozi kwiphecana lesisu.

Umhlaza wesisu waseTshayina uye waba "ngumbulali wokuqala wesizwe", malunga ne-50% yezigulane zomhlaza wesisu zenzeka e-China, kunye ne-60% phakathi kunye nasemva kwexesha.

Nokuba yeyiphi imeko entsha okanye ukufa, inani lilonke lomhlaza wesisu ligqithise umhlaza wemiphunga. Umhlaza wamathumbu ngowona unyangeka lula kuwo wonke umhlaza ngokuhlolwa kwangethuba. Yinqaba yokuqala yabantu ukoyisa umhlaza. Kuphela i-5% ye-Chinese colorectal cancers yafunyaniswa kwangethuba, kwaye i-60-70% yezigulane ezinomhlaza we-colorectal zifunyenwe zine-lymph nodes okanye i-metastases ekude. Izinga lokuphindaphinda laliphezulu ukuya kuma-30%.

I-Japan kunye ne-South Korea ikwangamazwe anezehlo eziphezulu zomhlaza wesisu, kodwa izinga lokuxilongwa kwabo kwangoko li-50-60%, kwaye ngaphezu kwe-90% yezigulane zinokunyangwa. Uphando lwasekhaya kunye nolwamazwe ngamazwe lubonisa ukuba amanyathelo okuhlola umhlaza we-colorectal anokunciphisa izehlo kunye nokufa komhlaza we-colorectal.

Kwiminyaka yakutshanje, ukongezelela eYurophu, kuMntla Merika, eJapan, eSingapore, kuMzantsi Korea, eTaiwan, naseHong Kong, kuye kwakho uhlolo olukhulu olukhokelwa ngurhulumente. Ukuhlolwa kwangethuba lokuxilongwa komhlaza wesisu kunethuba lokunyangwa ngokupheleleyo, ngokubaluleka okukhulu kwezentlalo kunye nexabiso lentengiso.

Ukwenzeka komhlaza womlomo wesibeleko yinkqubo ende ngokwentelekiso. Ukusuka kwi-polyps ukuya kwi-hyperplasia engaqhelekanga ukuya kumhlaza, ngokuqhelekileyo kuthatha ixesha elide, elinika ixesha lokuhlolwa komhlaza wesisu. Ukuhlolwa kwangaphambili okusebenzayo kunye nonyango lokungenelela kunokunciphisa izehlo zomhlaza nge-60% kunye nezinga lokufa ngama-80%.

I-2, Ukubaluleka kwe-calprotectin ekuhlolweni komsebenzi wamathumbu emathunjini

I-Calprotectin yi-calcium-zinc-binding protein ephuma kwi-neutrophils kunye ne-macrophages, ene-molecular weight ye-36,000, i-heterodimer eyenziwe ngumbutho ongekho-covalent we-chain chain MRP14 kunye ne-MRP8 enye yokukhanya, ye-S100. Iprotheni yosapho.

Ngoncwadi olubanzi lophando kunye nokuqinisekiswa kweklinikhi, i-calprotectin inovakalelo oluphezulu lokubona umhlaza we-colorectal kwaye ayichatshazelwa yinqanaba le-tumor, elinokufumaneka kwangethuba nangexesha elingenazimpawu. Ingasetyenziswa njengesiphawuli sovavanyo lomhlaza we-colorectal.

Uvakalelo lwe-fecal calprotectin, uvavanyo lwegazi lwe-fecal occult kunye ne-serum CEA yomhlaza we-colorectal yayingama-88.51%, 83.91% kunye ne-44.83%, ngokulandelanayo. Izinga elilungileyo lovavanyo lwegazi lobugqi kunye ne-serum ye-CEA kwizigulane ezinenqanaba D kunye nenqanaba A laliphantsi kakhulu kunezigulane ezinenqanaba C kunye ne-D. Kwakungekho mmahluko omkhulu kwizinga elihle le-fecal calprotectin kwizigulane ezinezigaba ezahlukeneyo IiDukes.

Uvakalelo lokuxilongwa kwe-fecal calprotectin kumhlaza we-rectal yafikelela kwi-92.7%, kwaye ixabiso elibi lokuxela kwangaphambili le-NPV lifikelele kwi-98.6%. I-calprotectin ye-fecal yomhlaza we-colorectal, ≥10mm i-polyps ye-colorectal iyonke ixabiso elibi lokuxela kwangaphambili i-NPV ifikelele kwi-97.2%.

Ukuza kuthi ga ngoku, ngaphezulu kwamazwe angama-20 anje nge-United States, iBritane, iCanada, iFrance, iJamani kunye neSwitzerland asebenzise i-calprotectin njengesalathiso esibalulekileyo sokuhlola isifo samathumbu kunye nomhlaza kubantu abasengozini enkulu yezifo zamathumbu, kwaye bavavanya ukudumba. isifo samathumbu. Iimpawu ezibalulekileyo ezisebenzayo kunye nokuphilisa zisetyenziswa ngokubanzi kwimisebenzi yeklinikhi.

I-3, Izinto eziluncedo ze-calprotectin kunye negazi lobugqi elidityanisiweyo lokufunyanwa kovavanyo lomhlaza wamathumbu

1. Kulula ukusebenza: isampuli enye, iziphumo zovavanyo ezininzi
2. Ayinakwandisa ubunzima bokusebenza kunye neendleko zesixhobo: isixhobo sibekwe, kwaye izixhobo zixhotyiswe ngokweemfuno.
3. Uvakalelo oluphezulu kunye neenkcukacha ezithile: isalathisi sokuvuvukala, ukuphuma kwegazi emathunjini
4. Inqanaba lovavanyo lwakwangoko: kwandisa amathuba ovavanyo lwe-adenocarcinoma kunye neepolyps
5. Ixabiso eliphantsi lokufumanisa, linokusetyenziswa njengemijelo ye-colonoscopy
6. Ukuzingisa: ukuhlolwa kwebhetshi yonyaka

Iimpawu eziqhelekileyo zomhlaza wesisu:

Ukuvutha kwamathumbu emathunjini - i-calprotectin, i-Dukes inqanaba linqanaba le-A kunye ne-B izigulane ezinovavanyo lwegazi lobugqi kunye ne-serum CEA isantya esilungileyo sisezantsi kakhulu kunezigulane ezine-C kunye ne-D isigaba, i-Dukes izigaba ezahlukeneyo zesigulane, izinga elihle le-fecal calprotectin Ukwahluka okuphawulekayo.

Ukopha kwesisu - igazi lobugqi, i-transferrin. I-gastrointestinal hemorrhage ibhekisela ekulahlekeni kwegazi nge-gastrointestinal tract ngenxa yezizathu ezahlukeneyo. Izizathu eziqhelekileyo zibandakanya ukuvuvukala kwendlela yokugaya ngokwayo, umonakalo womatshini, isifo se-vascular, i-tumor, kunye nezifo ze-visceral kwi-gastrointestinal tract. Uvavanyo lwegazi lobugqi yinkqubo kunye neendlela ezibalulekileyo zokuxilonga ukopha kwesisu.

4, Indlela yokukhangela i-calprotectin yefecal

Ikhithi yethu yokuvavanya i-calprotectin (indlela yegolide ye-colloidal) ingasetyenziselwa yodwa ukufumana i-semi-quantitatively ukubona i-calprotectin kwiisampuli zesitulo somntu. Inokusetyenziswa kwakhona kunye nochungechunge lwe-WIZ lwe-immunoassays.

I-calprotectin assay kit (i-fluorescence immunochromatography) inokufezekisa ukufumanisa ubuninzi, amanani achanekileyo amanani, kunye noluhlu olubanzi lomgca, ukwenzela ukuba kuphunyezwe umphumo wokuhlukanisa izifo zamathumbu.

Ikiti yovavanyo lwegazi lobugqi (indlela yegolide ye-colloidal) isetyenziselwa ukufumanisa umgangatho we-hemoglobin yomntu kwilindle lomntu, olulungele ukuxilonga ukopha kwesisu.